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Hydrosalpinx: Functional Surgery or Salpingectomy
Nomonde D Gumata
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:145-150]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1101 | FREE

Background: Hydrosalpinx is a common cause of female infertility1 and adversely affects the outcomes of in vitro fertilization (IVF). Although IVF is the main treatment, alternative treatments, such as salpingectomy and functional tubal surgery have been suggested.2 Previously, hydrosalpinx was diagnosed using tubal patency tests (transvaginal ultrasound, TVUS; hysterosalpingography, HSG; and laparoscopy), which do not assess tubal function hydrosalpinx, and salpingectomy was the main surgical treatment for hydrosalpinx prior to IVF.3 However, with modern tubal endoscopy (salpingoscopy and fertiloscopy)4-7 and their ability to assess tubal functional mucosa, functional tubal surgery can be considered for thin-walled hydrosalpinx and a healthy mucosa and salpingectomy performed for thin-walled hydrosalpinx with mucosal adhesions and thick-walled hydrosalpinx with absent mucosal folds.8
Aims and objectives: The aim of the review is to highlight the use of appropriate tubal function tests to help in making a choice between either salpingectomy or functional tubal surgery as the treatment for hydrosalpinges.
Materials and methods: A literature search was performed using the search engine Google, HighWire press, PubMed and SpringerLink. Selected papers were taken for further references. All articles, including randomized controlled trial (RCT) were included for the review.
Results: Vasquez et al8 suggested that mucosal adhesions are the most important factors in determining fertility outcomes especially in thin-walled hydrosalpinges. Several studies on hydrosalpinges have also shown that the absence of mucosal adhesions on salpingoscopy can identify patients who can benefit from advantages offered by reconstructive surgery.3-7 Boer Meisel et al9 showed that patients with thin-walled hydrosalpinges and well preserved mucosa had an intrauterine pregnancy rate of 77% and a tubal pregnancy rate of 4% following reconstructive surgery.9 Vasquez et al8 in their prospective study showed that thin-walled hydrosalpinges with a normal or flattened mucosa, but without mucosal adhesions were associated with a 58% pregnancy rate and low risk of tubal pregnancy.8 Their study also found that thick-walled hydrosalpinges with mucosal adhesions have a statistically significant lower intrauterine pregnancy rate.8 Dechaud et al10 showed that salpingectomy for thick-walled hydrosalpinges improved the outcome of IVF.
Conclusion: An appropriate tubal mucosal assessment should be a routine prior to deciding upon further management of hydrosalpinx. Functional tubal surgery should be preferred in mild forms of hydrosalpinx and salpingectomy reserved for severe forms of hydrosalpinx.
Keywords: Hydrosalpinx, Salpingectomy, Functional tubal surgery, Fimbrioplasty, Salpingostomy, Uterine tubal anastomosis, Tubal function tests, Salpingoscopy and Fertiloscopy.
How to Cite
Gumata ND. Hydrosalpinx: Functional Surgery or Salpingectomy. World J Laparoscopic Surg. 2010;3(3):145-150

Inguinodynia after Laparoscopic Inguinal Hernia Repair
Abdulkareem Aldoseri
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:135-138]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1099 | FREE

Objectives: The objective of this literature review is to see if changing the site of the mesh from outside to inside has any effect on the occurrence of posthernia repair pain. And also to review different author's opinion about causes occurrence and management of postmesh inguinal pain.
Materials and methods: Literature review conducted using Google search engine, Google books, HighWire press, using keywords like postinguinal hernia pain, complications of hernia surgery, laparoscopic mesh repair.
Results: Chronic pain after surgery has been recently a neglected topic. The extent of the problem first came to light in a survey of patients attending pain clinics in Scotland and the north of England. This survey showed that about 20% of patients attending chronic pain clinics implicated surgery as one of the causes of their chronic pain, and in about half of these; it was the sole cause.1 Inguinal hernia repair is a common surgical procedure performed worldwide with an annual procedural rate of 2,800 per million people in the United States alone. In England and Wales, 70,322 primary inguinal herniorrhaphies were performed in National Health Service Hospitals between 1998 and 1999. Inguinal herniorrhaphy is often performed as a daycase procedure with minimum postoperative morbidity. After inguinal hernia repair, patients can return to work early and enjoy a good quality of life. Since modern surgical thinking concerning inguinal hernia repair was established by Bassini in 1884, various modifications have been developed to improve outcome. Despite the fact that recent meta-analyses have suggested that laparoscopic surgery is associated with less postoperative pain and more rapid return to normal activity, open mesh repair is still recommended by the National Institute for Clinical Excellence.
Keywords: Inguinodynia, Laparoscopic, Inguinal hernia, Complication of Inguinal hernia.
How to Cite
Aldoseri A. Inguinodynia after Laparoscopic Inguinal Hernia Repair. World J Laparoscopic Surg. 2010;3(3):135-138

A Review of the Role of Laparoscopic Biopsy in Cases of Abdominal Lymphadenopathy
Amitabh Thakur
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:139-143]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1100 | FREE

Lymphadenopathy, identified incidentally during computed tomography, is a common clinical scenario faced by clinicians, and often poses a diagnostic challenge mandating a tissue diagnosis. In the absence of palpable peripheral nodes, tissue has to be obtained from the abdominal nodes by image guided biopsy or surgery. In this context, a laparoscopic biopsy avoids the morbidity of a laparotomy.
Keywords: Abdomen, Biopsy, Laparoscopy, Lymph node, Lymphoma, Tuberculosis.
How to Cite
Thakur A. A Review of the Role of Laparoscopic Biopsy in Cases of Abdominal Lymphadenopathy. World J Laparoscopic Surg. 2010;3(3):139-143

The Role of Laparoscopy in the Management of Gynecologic Surgical Emergencies: A Review of Literature
Andrew Kilonzo
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:127-130]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1097 | FREE

Minimal access surgery is increasingly becoming the preferred approach to surgical treatment. Experience in the last 15 to 20 years has established the efficacy and indeed safety of laparoscopic surgery in general surgical and gynecologic practice.
Laparoscopic treatment in acute gynecologic emergencies raises questions of safety and feasibility when compared to open laparotomy.
The objective of this study was to review the literature on the use of laparoscopy in the treatment of gynecologic emergencies so as to determine its role in current and future practice.
The findings of this study indicate that laparoscopic surgery for gynecologic emergencies is feasible and safe. Further studies are needed to establish the safety of laparoscopic surgery for nonobstetric emergencies in late pregnancy.
Keywords: Laparoscopy in gynecological emergency, Abdominal injury, Abdominal trauma.
How to Cite
Kilonzo A. The Role of Laparoscopy in the Management of Gynecologic Surgical Emergencies: A Review of Literature. World J Laparoscopic Surg. 2010;3(3):127-130

Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases
Nina Irawati
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:109-112]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1093 | FREE

Background: We report our two initial experiences in the treatment of thyroid disease with endoscopic thyroidectomy. Minimally invasive video-assisted thyroidectomy (MIVAT) was initially introduced by Miccoli. The modification was made by using axillary and breast approach with CO2 insufflation.
Method: A young woman patient with 5 cm right lobe thyroid disease, suspected benign. From physical examination, sonography and FNAB findings were categorized as benign case. Thyroid function test was within normal limit. She was operated with endoscopic right lobectomy. The procedure was carried out through incision of 5-10 mm axillary and breast. The right lobectomy procedure was performed by dedicated instrument. No drain needed. The pathology result was follicular carcinoma, so further treatment needed. Other patient, a woman with 4 cm right lobe thyroid cyst. FNAB proved benign, was operated with the same procedure, and pathology result was benign cyst.
Result: Duration of first operation was 300 minutes and the second one was 120 minutes, minimal blood loss, and no major complication. Patients were discharged 24 hours after operation. Cosmetic results and postoperative pain were excellent. Slight swelling on their necks was found and reduced after 48 hours. Pain around shoulder until day-7 postoperation and significantly disappeared after 10 days.
Conclusion: We reported two cases, which were operated by endoscopic right lobectomy as a safe, reproducible technique with an indication in a minority of patients/candidates to thyroidectomy and is characterized by a better postoperative discomfort. The duration of operation would be a curve learning for each surgeon who wishes to perform it.
Keywords: Endoscopic thyroidectomy, Axillary-breast approach.
How to Cite
Irawati N. Endoscopic Right Lobectomy Axillary-breast Approach: Report of Two Cases. World J Laparoscopic Surg. 2010;3(3):109-112

Severe Hemobilia from Hepatic Artery Pseudoaneurysm after Laparoscopic Cholecystectomy: A Case Report and Review of Literature
Fabio Sansonna, Stefano Boati, Raffella Sguinzi, Raffaele Pugliese Carmelo Migliorisi,Francesco Pugliese
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:117-121]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1095 | FREE

Background: Hemobilia is a rare, jeopardizing complication of laparoscopic cholecystectomy coming upon patients generally within 4 weeks from surgery. The first line management is angiographic coil embolization of hepatic arteries, which checks the majority of bleedings whereas in a minority of cases, a second embolization or even laparotomy is needed.
Case presentation: We describe the case history of a patient who had laparoscopic cholecystectomy complicated three weeks later by massive hemobilia. The cause of hemorrhage was a pseudoaneurysm of a right hepatic artery branching off the superior mesenteric artery. This complication was managed successfully by one stage angiographic embolization with full recovery of the patient.
Keywords: Hemobilia, Laparoscopic cholecystectomy, Angiographic embolization, Thermal damage, Ultrasonic dissection.
How to Cite
Sansonna F, Boati S, Sguinzi R, Pugliese R, Migliorisi C, Pugliese F. Severe Hemobilia from Hepatic Artery Pseudoaneurysm after Laparoscopic Cholecystectomy: A Case Report and Review of Literature. World J Laparoscopic Surg. 2010;3(3):117-121

To Evaluate the Efficacy of Laparoscopic versus Open Surgical Management of the Tubal Pregnancy and its Effects on Future Pregnancy
Amardeep Bhimrao Tembhare
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:153-158]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1103 | FREE

Ectopic pregnancy is the most common cause of maternal death in early pregnancy and its incidence is rising. Most of the ectopic pregnancies occur in the young age group and subsequent fertility is an important issue. There is no consensus in the literature regarding conservative laparoscopic versus radical treatment of tubal pregnancy in terms of future reproductive performance. There are no randomized controlled trials of sufficient power, and meta-analysis of studies has shown different results with different investigators. But in certain studies laparoscopic surgery has advantages over open surgery and results in higher rates of subsequent intrauterine pregnancies and a lower rate of ectopic pregnancy.
Background: In the treatment of tubal ectopic pregnancy (EP), laparoscopic surgery remains the cornerstone of treatment (Cochrane Database 2007). In the absence of randomized data, the question as to whether surgical treatment should be performed either conservatively (salpingostomy) or radically (salpingectomy) in women with desire for future pregnancy is subject to ongoing debate (Mol et al 2008).
Since the first study demonstrated the potential effectiveness of salpingostomy, this treatment has been compared with salpingectomy in numerous nonrandomized studies (Stromme et al 1962, Mol et al 2008). Pooled data showed no beneficial effect of salpingostomy on intrauterine pregnancy (IUP) whereas there is an increased risk of repeat EP (Clausen 1996, Yao et al 1997, Mol et al 2008). Based on these findings, the Royal College of Obstetricians and Gynecologists guideline advises salpingectomy as the preferred standard surgical approach for tubal EP (RCOG 2004). However, there are good reasons to question this advice. Interpretation of the pooled data is troublesome, since many of the original studies failed to report essential details, e.g. time to pregnancy, presence of the desire for future pregnancy, and whether subsequent pregnancies occurred either spontaneously or after fertility treatment, such as in vitro fertilization (IVF). Only a few nonrandomized studies have taken these matters into account and came to different conclusions (Silva et al 1993, Job spira et al 1996, Mol et al 1998, Bouyer et al 2000, Bangsgaard et al 2003, Tahseen et al 2003, Mol et al 2008). The IUP rates were higher and the time to an IUP was shorter after salpingostomy compared to salpingectomy. Especially in women with history of bilateral tubal pathology, salpingostomy offered better IUP rates than salpingectomy, albeit at the cost of an increased risk for repeat EP (Silva et al 1993, Job spira et al 1996, Mol et al 1998, Bangsgaard et al 2003, Mol et al 2008). In women without history of tubal pathology, this benefit was less clear and also in these women there was an increased risk of repeat EP (Mol et al 1998, Mol et al 2008). In view of these data, it has been felt that the most effective type of surgery for women with a tubal EP in the presence of contralateral tubal pathology with desire for future pregnancy is salpingostomy. In women without contralateral tubal pathology, the most optimal surgical treatment is currently unknown.
Keywords: Ectopic pregnancy, Operative laparoscopy, Laparoscopic, Laparotomy salpingectomy, Surgical treatment, Minimal access surgery, Future pregnancy.
How to Cite
Tembhare AB. To Evaluate the Efficacy of Laparoscopic versus Open Surgical Management of the Tubal Pregnancy and its Effects on Future Pregnancy. World J Laparoscopic Surg. 2010;3(3):153-158

Hysteroscopic Sterilization
Bharathi Rajanna
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:159-164]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1104 | FREE

Female sterilization is the most widely accepted contraception in the world today. From a practical perspective, gynecologists are at constant drive to provide effective, safe, least discomfort/pain and economical contraception to the couple. With the advent of hysteroscopic surgery innovation in the form of better optics, endoscopes, camera, equipment, and insufflation machines revolutionized the surgery. This review will discuss the evolution of different hysteroscopic sterilization methods, including the past, present and upcoming devices. However, concerns remain about the absolute irreversibility of the method of sterilization. Researchers have failed to find solution to meet all the criteria. But this route obviates surgical incision and requires local anesthesia or intravenous sedation. The safety, tolerability and efficacy of hysteroscopically placed device are discussed in depth. This article will certainly help the clinicians to keep abreast of latest advances in contraception and practice in broader perspective despite the availability of limited literature.
Keywords: Transcervical sterilization, Micro-insert device, Hysterosalpingogram (HSG).
How to Cite
Rajanna B. Hysteroscopic Sterilization. World J Laparoscopic Surg. 2010;3(3):159-164

Ureteric Injuries during Laparoscopic Gynecological Operations
Evin NilUgurlu
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:123-125]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1096 | FREE

Objective: To review the literature regarding ureteral injuries that occured during laparoscopic gynecological operations and determine preventive methods.
Material and methods: We have evaluated all the articles related with ureteral injuries of laparoscopic operations between the years 2000 and 2010, and selected 14 of them.
Results: The rate of injury is 0.093 to 1.1%. Most of the injuries occured at distal third of ureter due to close proximity to uterine artery. Unfortunately, most of the injuries were diagnosed postoperatively. The most common injury type was thermal injury, and the treatment of choice was often by laparotomy, particularly ureteroneocystostomy.The best way to prevent injury is a through knowledge of pelvic anatomy and principles of electrosurgery together with enough expertise.
Conclusion: Ureteric injury prevention and if occured, timely diagnosis is prudent to prevent serious morbidities.
Keywords: Ureteral injury, Laparoscopic gynecologic operation, Prevention.
How to Cite
Ugurlu EN. Ureteric Injuries during Laparoscopic Gynecological Operations. World J Laparoscopic Surg. 2010;3(3):123-125

Laparoscopic Management of Biliary Ascariasis: A Case Report and Review of Literature
Khairi Hajaji, Hisham Aljohary, Hassan Althani
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:113-115]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1094 | FREE

Acute pancreatitis due to Ascaris lumbricoides is a known etiology but very rare in Qatar. The diagnosis can be difficult because of the low index of suspicion. We report a case of 25-year-old Philippine patient living in Qatar who developed an acute pancreatitis due to Ascaris lumbricoides and was diagnosed initially as biliary pancreatitis. We proceeded with laparoscopic cholecystectomy and intraoperative cholangiogram which revealed Ascaris in the common bile duct. Transcystic extraction of a living worm from the common bile duct was done. This is the first case report of acute pancreatitis due to Ascaris lumbricoides which had laparoscopic transcystic extraction of a living worm from the common bile duct.
Background: Ascaris lumbricoides as etiology to acute pancreatitis has never been described in Qatar whereas in developing tropical and subtropical areas, Ascaris lumbricoides is found in human gastrointestinal tract with greater prevalence.1 Although the infection can be asymptomatic, in some cases the adult parasite can invade the biliary or pancreatic ducts and cause obstruction with development of cholecystitis, cholangitis, and pancreatitis and hepatic abscesses.2 We report a case of a patient with biliary ascariasis induced acute pancreatitis.
Conclusion: We recommend the use of this laparoscopic approach for treatment of such uncommon pathology, if surgical intervention is needed. The differential diagnosis of pancreatitis should be expanded to include ascariasis in patients who come from population at risk. Knowledge of clinical symptoms, complications, and diagnostic and therapeutic options are of paramount importance for all health professionals.
Keywords: Biliary ascariasis, Laparoscopy in ascariasis, Management of ascariasis.
How to Cite
Hajaji K, Aljohary H, Althani H. Laparoscopic Management of Biliary Ascariasis: A Case Report and Review of Literature. World J Laparoscopic Surg. 2010;3(3):113-115

Reproductive Performance in Hysteroscopic Metroplasty
Priti Nivendkar
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:131-134]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1098 | FREE

Background: This study was to ascertain reproductive better outcome in hysteroscopic metroplasty, the literature to support that removal of septum improves pregnancy rates in women with bad obstetric history. However, its role in patients with otherwise unexplained infertility is still not clear due to paucity of enough evidence.
Objective: To assess reproductive performance in women with septate uterus and otherwise unexplained infertility after hysteroscopic metroplasty.
Materials and methods: Eight women with septate uterus and otherwise unexplained primary infertility were included in the study. All these women underwent hysteroscopic septal resection. Reproductive performance of these women within one year of surgery was studied and analyzed.
Result: Forty women (45.83%) conceived within one year of surgery. Only six women (12%) had spontaneous abortions and only five (15%) had preterm delivery.
Conclusion: Hysteroscopic metroplasty in women with septate uterus significantly improves the reproductive performance. Septate uterus is not a primary factor of infertility. Hysteroscopic metroplasty restores normal uterine cavity with a good uterine vascularization to have better reproductive outcome.
Keywords: Hysteroscopy, Metroplasty, Open metroplasty, Septate uterus, Bicornuate uterus.
How to Cite
Nivendkar P. Reproductive Performance in Hysteroscopic Metroplasty. World J Laparoscopic Surg. 2010;3(3):131-134

Tissue Glue in Laparoscopic Inguinal Hernia Repair: A Retrospective Comparative Analysis
Abhijit Mahanta, RK Mishra
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:165-174]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1105 | FREE

During the last two decades, there have been two revolutions in inguinal hernia repair surgery. First, the introduction of tension-free hernia repair by Liechtenstein in 1989 and then the application of laparoscopic surgery to the treatment of inguinal hernia in the early 1990s. In this context, the choice of mesh fixation methods being an integral part of this procedure remains a topic of arguments and discussions in laparoscopic inguinal hernia repair. There exist many methods of mesh fixation like polyglactin suture, titanium spiral tacks, nitinol anchors and fibrin glue.
Fixation usually uses staples that can lead to nerve injury and chronic postoperative pain. Laparoscopic repairs are associated with a risk of chronic pain of upto 22.5%. The use of fibrin glue may represent an alternative method of mesh fixation preventing the risk of nerve injury.
Keywords: Fibrin sealant, Tissue glue, Fibrin glue, Tisseel, Inguinal hernia, Laparoscopic herniorrhaphy, TAPP, TEP, Mesh fixation.
How to Cite
Mahanta A, Mishra RK. Tissue Glue in Laparoscopic Inguinal Hernia Repair: A Retrospective Comparative Analysis. World J Laparoscopic Surg. 2010;3(3):165-174

Single Access Laparoscopic Nephrectomy
Issac Syiem
[Year:2010] [Month:September-December] [Volume:3 ] [Number:3] [Pages:66] [Pages No:151-152]
Full Text HTML | Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10007-1102 | FREE

Laparoscopic nephrectomy has assumed a central role in the management of kidney diseases. Laparoscopy, inspite of its less morbidity than open surgery, still requires several incisions. These incisions carry risks of bleeding, ventral hernia, damage to internal organs and decreased cosmesis.
An alternative to laparoscopy is the single access or keyhole surgery. This keyhole surgery utilizes the new laparoscopy access port (R-Port), single port access (SPA) procedure, one port umbilical surgery (OPUS), the " belly button" entry, natural orifice transluminal endoscopic surgery, and the magnetic anchoring and guidance system (MAGS) technology.
Keywords: SILS, SILS nephrectomy, Laparoscopic nephrectomy.
How to Cite
Syiem I. Single Access Laparoscopic Nephrectomy. World J Laparoscopic Surg. 2010;3(3):151-152


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